Professor Tian Jinzhou 's Academic Thought And Clinical Experience And Its Treatment Of Alzheimer' S Disease

Object:To review professor Tian (Jinzhou)’s steps of being successful, summarize his academic thought and clinical experience, spotlighting the one in treating Alzheimer’s disease (AD), and study the train of thought in diagnosis and treatment, thus to grasp Prof. Tian’s academic thought and inherit his clinical experience comprehensively and systematically.Methods:1. The data of Prof. Tian’s making diagnoses and treating patients in the past three years were collected by being with him when he was doing clinic; his academic thought and clinical experience were acquainted by communicating with him during his clinic hours or in his usual time, and reading his works, papers, or the ancient books he appointed; and based on all the above, Prof. Tian’s academic thought and clinical experience were summarized.2.101 cases of AD treating by Prof. Tian were selected; information of symptoms, diagnoses, methods of treating and medication used were detailed when the patients first came. Frequency of medical herbs used, syndrome differenciation and treating methods were counted; correlation degrees between treating method and herbs, symptoms and herbs, and among herbs were analyzed by association rules ICA algorithm, and by which, the visual point line diagrams were drew; and then, results and conclusion were revised and improved by interviewing Prof. Tian. All the above were aided by the Intelligent Analysis System for Large Data of TCM Diagnosis and Treatment.Results:1. Prof. Tian’s succeeding steps can be summarized as:Graduated from Beijing University of Chinese Medicine majoring in internal medicine of TCM, filling himself with the study of ancient classic books on the field; acknowledged Prof. Dong (Jianhua) and Prof. Wang (Yongyan) as his masters; and formed his own academic thought and clinical experience by inheriting his masters’2. On Prof. Tian’s academic thought:Prof. Tian advocates the trilogy in treating a patient, which are making diagnosis, diagnosing syndrome differenciations and composing medical herbs as medication. No one should be missed and making diagnosis is the most important. He believes that in the course of treating a patient, diagnosing the illness must go before diagnosing the syndrome differenciation. And diagnosing syndrome differenciation is the core of treating a patient by TCM, the basis of composing herbs and the key to test the effectiveness of medicine.Prof. Tian takes root in TCM, insist on the combination of Chinese medicine and Western medicine. He emphasizes the importance of the four diagnostic methods of TCM, especially the tongue and pulse examinations, and meanwhile, he also stresses on the modern examinations.He lays stress on the function of kidney and spleen in the brain’s occurrence, development and change, thus points out that reinforcement of spleen and kidney can also reinforce the brain.Prof. Tian thinks that phlegm turbidity and blood stasis are the pathological factors in brain diseases, especially in the development of dementia. The two mixing with and influencing each other, result in the repeated symptoms and deterioration of the disease. Tongue and pulse examination is important in the diagnosis of phlegm turbidity and blood stasis. Patients with dementia usually manifested themselves in purplish tongue, with petechia or ecchymosis, and with greasy tongue fur.Prof. Tian pointed out that AD is a kind of chronic progressive central nervous system degeneration disease. In treating it, we must abide by the principle of "step by step", dose of herbs light, and promote qi and blood flow by regulating yin and yang and reinforce the middle burner, thus resulting in the recovery of brain function.3. On Prof. Tian’s clinical experienceBriefly on the treatment of AD:making diagnosis based on the development of disease and the change of syndrome differenciation, reinforcing spleen and kidney in plateau period, dissipating phlegm, soothing liver and activating blood in in wave period, and removing toxic materials in recovering period, with emphasis on the treating of accompanying symptoms and the healthy education.Briefly on the treatment of normal pressure hydrocephalus by reinforcing kidney and brain marrow:Prof. Tian believes that the key to TCM pathological mechanism of the disease is asthenia of kidney and brain marrow and mixture of evil dampness and stasis, and that is deficiency in the root and excess in the branch; thus the main treatment principles should be reinforcing kidney and brain marrow, activating blood flow and resolving dampness, and when the disease develops, we can change to reinforcing spleen and resolving dampness, stopping wind and dredging collaterals, nourishing heart to tranquilize mind, and clearing away phlegm heat.Briefly on the treatment of depression by regulating liver and heart:Prof. Tian thinks that the stasis of qi is the key to the onset of the disease, so the principle must be soothing liver to relieve depression from the start through to completion, and also we can clear liver to reduce fire evil, activate blood flow to resolve stasis, dissipate phlegm to resolve stagnation, nourish yin to supplement blood, and reinforce spleen to nourish heart.Briefly on the treatment of insomnia:Prof. Tian inspired from the principle of "stasis and asthenia must result from long-term disease" by Ye Tianshi, a famous doctor in ancient China, and pointed that activating blood flow to tranquilize mind in the key to treat insomnia.Briefly on the treatment of AD with mental disorders by soothing liver and clearing heart:Patients with AD usually suffer from mental disorders, but we don’t know the mechanism, and there are different views about using antipsychotic drugs. Prof. Tian showed great effectiveness in treating the disease by soothing liver and clearing heart.Briefly on the treatment of dizziness with the syndrome differenciation of excess of liver yang and blood stagnation:Prof. Tian believes that patients suffered from dizziness with high blood pressure are caused by the excess of liver yang and blood stagnation, and in treating it, we can use the method of soothing liver and dredging collaterals.Briefly of the treatment of headache due to internal injury by regulating the liver:Prof. Tian thinks that headache due to internal injury is closely related with dysfunction of liver. Soothing liver and dredging collaterals is effective in treating the disease, and the representative herb formula is Chuanxiong Ding Tong Yin. In the formula, rhizome of Chuanxiong functions to activate blood flow and dredge collaterals to stop pain, so the dose should be heavy.Briefly on the treatment of gastroesophageal reflux cough by the principle of lung-stomach closely related with each other:Prof. Tian believes that the mechanism of gastroesophageal reflux cough is the asthenia of stomach-qi resulting in its adverse flow and the failure of lung to depurate and descend. The frequently used herbal formula is Xuanfu Daizheshi Tang.Briefly on the treatment of anorexia by mixing herbs in properties of sour and sweet to transform into yin:In treating patients suffered from poor appetite, Prof. Tian frequently nourish yin to reinforce stomach, mixing herbs in properties of sour and sweet to transform into yin. Peony and licorice are the key pairs and the most frequently used herbs. Other herbs included plum, rehmanniae, and Ophiopogon japonicas.Briefly on the treatment of Parkinson’s disease by nourishing liver and kidney, and soothing liver to stop wind evil:Parkinson’s disease can be classified to "Dianzhen" in TCM. Prof. Tian then classified it in "the disease of brain marrow", and mechanism is asthenia in the root and sthenia in the branch. Lacking in liver blood and kidney essence is the main problem, with wind evil, phlegm and stasis as supplement. To cure it we should nourishing liver and kidney, and soothing liver to stop wind evil.Briefly on the treatment of recurrent oral ulcer by nourishing yin to clear heat evil:Recurrent oral ulcer is named by TCM as "kouchuang" or "koumi". Prof. Tian treats the disease as sores; he believes that fire-heat evil is the main pathological factor and locates the disease at heart and spleen. Long lasting disease can result in the damage of yin and a mixture of asthenia and sthenia.Briefly on the treatment of senile constipation by reinforcing kidney and spleen and regulating qi flow:Prof. Tian thinks that the mechanism of the disease is the lacking of kidney essence, related with dysfunction of spleen and qi activity. And it is effective to reinforce kidney and spleen and regulate qi flow in treating it.Briefly on the treatment of tinnitus cerebri by reinforcing kidney and spleen and replenishing qi for lifting:Prof. Tian believes that tinnitus cerebri is caused by the void of brain marrow and the key to solve the problem is to reinforce kidney, replenish spleen and dredge collaterals.Prof. Tian inherited his master, Prof. Dong’s academic thought well, and is good at using herb pairs. This paper analyzed some herb pairs such as:calamus, turmeric, turtle shell, mahonia, agrimony, figwort root, dwarf lilyturf root, turmeric, flos albiziae, hypericum perforatum, paeonol, digupi, salvia miltiorrhiza, zaoren, schisandra, panax notoginseng, scorpion, dendrobium, ebony, raw licorice, gastrodia tuber, ramulus uncariae cumuncis.4. Based on the analysis of 101 medical records of Alzheimer’s disease, the frequency of each herb, each therapy, and the association rules among them were concluded,13 core combinations between two herbs and 9 between three herbs were extracted from the database. Conclusion:Professor TIANJINZhou is experienced in replenishing essence to reinforce the kidney, invigorating the spleen to resolve phlegm, complex formula for concomitant syndromes, using animal medicine, treating knot of fire, phlegm, blood stasis and poison. Association rules algorithm has important practical value in analyzing clinical experiences of senior TCM doctors.